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behavioral changes beginning 5 weeks after TBI in child
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behavioral changes beginning 5 weeks after TBI in child

My 4-year-old daughter had a bad fall on Feb. 14, and we were told she had a mild concussion (with impact to the forehead).  In the days/weeks immediately afterward, there were several noticeable behavioral changes but we were told that these would subside within a week to 2 months.  

However, about 5 weeks after the injury, she began showing dramatic behavioral changes, including:
* bizarre/inappropriate emotional responses (such as uncontrollable giggling in response to things that previously would have upset her, which then spirals into periods of extremely hyper behavior);
* dramatically diminished attention span;
* sudden inability to focus on more than a sentence at a time.

We saw a pediatric neurologist who told us that these behaviors ("disinhibited behaviors") are often linked to frontal lobe injuries.  He assured us that they would pass on their own.  But this is inconsistent with recent research I've seen discussing the type of ongoing brain cell damage that may occur weeks after a frontal cortex concussion, particularly in children.  Also, several articles indicate that significant behavioral and learning issues frequently follow even a mild concussion.  When I asked him about this research -- hoping he would be able to explain why they did not apply to Violet's case -- he did not seem familiar with it.

Several physician friends I've spoken to have said that the research as to TBIs in children is rapidly evolving, and that we should seek a specialist with expertise in this specific area.  So I've been making calls and sending emails, but it's been surprisingly difficult and slow.  

My specific questions are:  
(a)  does the delayed onset of these symptoms (about 5 weeks after the injury) suggest that they're more likely to be long-term?  
(b)  would you be able to direct me to any specialists or brain injury centers in the NYC area that might be an appropriate next step for us?  

I would be very, very grateful for any advice or suggestions.  
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Your daughter may be suffering from postconcussive syndrome. This syndrome typically includes headache, irritability, and sleep disturbance. These symptoms can last up to several months; however, a few will continue to have symptoms (>1 year). I am not sure what research you are mentioning without the citation. I would suggest that you have your daughter evaluated by a neuro-psychologist. If a specific deficit is identified, cognitive rehab may be appropriate.  

Thank you for using the forum, I hope you find this information useful, good luck.
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